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    Surgical devices for imposing a negative pressure to stabilize cardiac tissue during surgery
    62.
    发明授权
    Surgical devices for imposing a negative pressure to stabilize cardiac tissue during surgery 失效

    公开(公告)号：US06893391B2

    公开(公告)日：2005-05-17

    申请号：US10020451

    申请日：2001-12-14

    申请人： Charles S. Taylor

    发明人： Charles S. Taylor

    IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/30 ,  A61B17/34 ,  A61B19/00 ,  A61F2/00

    CPC分类号： A61B17/0218 ,  A61B17/00 ,  A61B90/40 ,  A61B2017/00243 ,  A61B2017/00703 ,  A61B2017/0243 ,  A61B2017/306 ,  A61B2017/3488

    摘要： The invention is devices and techniques which use a negative (suction) pressure or vacuum, applied through a surgical instrument, to fix the position of a portion of the surface of a beating heart so that a surgical procedure can be more easily performed. The devices apply a negative pressure at several points on the outer surface of the heart such that a portion of the heart is fixed in place by the suction imposed through the surgical instrument. Because the instrument fixes the position of the tissue, and because the instruments remain at a constant distance from the particular portion of the heart where the surgery is being performed, the device may also serve as a support or platform so that other surgical instruments or devices can be advantageously used at the site. In certain preferred embodiments, the devices described herein have structures to facilitate the use of additional surgical instruments such that the placement of negative pressure device permit the surgeon to advantageously manipulate the other instruments during surgery. The negative pressure is preferably imposed through a plurality of ports which may be disposed in a substantially planar surface of the instrument which contacts the cardiac tissue.

    Surgical instruments for making precise incisions in a cardiac vessel
    65.
    发明授权
    Surgical instruments for making precise incisions in a cardiac vessel 有权
    用于在心脏血管中进行精确切口的手术器械

    公开(公告)号：US06387108B1

    公开(公告)日：2002-05-14

    申请号：US09541851

    申请日：2000-04-03

    申请人： Charles S. Taylor ,  John J. Frantzen ,  Ivan Sepetka

    发明人： Charles S. Taylor ,  John J. Frantzen ,  Ivan Sepetka

    IPC分类号： A61B1732

    CPC分类号： A61B17/32 ,  A61B17/320016 ,  A61B2017/00243 ,  A61B2017/00703 ,  A61B2017/00778 ,  A61B2017/2925 ,  A61B2017/320052

    摘要： The invention is surgical instruments which facilitate substantially linear incisions, especially through the wall of vessels, such as arteries, which have been specifically designed for coronary artery bypass graft procedures (CABG) on the beating heart. The instruments of the invention are particularly useful to create the incision in the artery to which the bypass graft is sewed, typically the left anterior descending artery (LAD). The instruments of the invention allow incisions to be rapidly made, precisely measured, and cleanly formed so that a bypass graft can be rapidly sewn in place. In one embodiment, the invention is comprised of a hand-held instrument with a curved cutting edge formed on the interior edge of a curved or arcuitous segment located near the end of the instrument. The tip of the instrument has a point of penetrating the vessel wall. The point may have several alternate shapes to facilitate penetration of the vessel wall while maximizing the trauma to the surrounding tissue. Another embodiment is comprised of a hand-held instrument with moveable member such that the incision is created by engaging a cutting blade against a stop with the tissue being cut therebetween. This instrument is also constructed to facilitate a rapid linear incisions in a vessel while minimizing the possibility for damage to the surrounding tissue. In another embodiment, the instrument features a motion-cancelling member which compensates for the movement of the target surface to be incised. This embodiment has a cutting blade which is manipulated form handle which is isolated from the movement of the tissue containing or proximate to the target of the incision. The instruments facilitate the invasive cardiac procedures by creating linear incisions quickly without undue trauma to surrounding tissue and without excess loss of blood.

    摘要翻译： 本发明是促进基本上线性切口的手术器械，特别是通过在搏动心脏上专门设计用于冠状动脉旁路移植手术（CABG）的血管如动脉壁。 本发明的器械特别可用于在旁路移植物缝合的动脉中形成切口，通常为左前降支动脉（LAD）。 本发明的仪器允许快速地进行切割，精确地测量和清洁地形成切口，使得旁路移植物能够快速地缝合到位。 在一个实施例中，本发明包括具有弯曲切割边缘的手持式仪器，其形成在位于靠近仪器端部的弯曲或直立部分的内边缘上。 仪器的尖端具有穿透血管壁的点。 该点可以具有几种替代形状，以促进血管壁的穿透，同时使周围组织的创伤最大化。 另一个实施例包括具有可移动构件的手持式仪器，使得通过将切割刀片接合在止动件上而在其间切割的组织而产生切口。 该仪器还构造成便于在容器中快速线性切口，同时最小化对周围组织的损伤的可能性。 在另一个实施例中，仪器具有补偿待切割的目标表面的移动的运动消除构件。 该实施例具有切割刀片，该切割刀片从手柄被操纵，所述切割刀片与包含或接近切口的靶标的组织的运动隔离。 这些仪器通过快速创建线性切口来促进侵入性心脏手术，而不会对周围组织造成不必要的创伤，而不会导致血液过多的流失。

    Surgical instrument for facilitating the detachment of an artery and the like
    66.
    发明授权
    Surgical instrument for facilitating the detachment of an artery and the like 失效
    用于促进动脉等的分离的手术器械

    公开(公告)号：US06280455B1

    公开(公告)日：2001-08-28

    申请号：US09243742

    申请日：1999-02-03

    申请人： Richard S. Ginn ,  Hani Shennib ,  Charles S. Taylor ,  Ivan Sepetka

    发明人： Richard S. Ginn ,  Hani Shennib ,  Charles S. Taylor ,  Ivan Sepetka

    IPC分类号： A61B1700

    CPC分类号： A61B17/00008 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/320016 ,  A61B2017/00867 ,  A61B2017/00969 ,  A61B2017/2905 ,  A61B2017/2927 ,  A61B2018/00916 ,  A61B2018/1253 ,  A61B2018/1407 ,  A61B2018/1435

    摘要： A surgical instrument is configured to aid in performing a procedure of detaching an internal mammary artery (IMA) and the like, from the connecting tissues and side branch vessels which surround the artery in its native location, wherein the detaching procedure is preliminary to the performing of a coronary artery bypass grafting procedure and wherein the IMA is detached via a minimally invasive thoracotomy. To this end, an elongated slender rod includes a handle at its proximal end and an artery engaging loop, arc, fork configuration, or hook at its distal working end. Embodiments may incorporate electrosurgical capability or electrical insulation. A surgeon thus has means for harvesting an intact and undamaged graft vessel from its native location through a minimally invasive incision with enhanced speed, visibility, and freedom of motion.

    摘要翻译： 手术器械被配置为有助于执行从其周围的动脉周围的连接组织和侧分支血管分离内部乳腺动脉（IMA）等的步骤，其中分离程序是执行的初步 的冠状动脉旁路移植手术，其中通过微创开胸术分离IMA。 为此，细长杆在其近端包括手柄，在其远端工作端处包括动脉接合环，弧形，叉形结构或钩。 实施例可以包括电外科能力或电绝缘。 因此，外科医生具有通过具有增强的速度，可见性和运动自由的微创切口从其原始位置收集完整且未损坏的移植血管的手段。

    Surgical instrument for cardiac valve repair on the beating heart
    67.
    发明授权
    Surgical instrument for cardiac valve repair on the beating heart 失效
    手术器械用于心脏瓣膜修复的跳动心脏

    公开(公告)号：US06258069B1

    公开(公告)日：2001-07-10

    申请号：US09371211

    申请日：1999-08-10

    申请人： Alain Carpentier ,  Charles S. Taylor

    发明人： Alain Carpentier ,  Charles S. Taylor

    IPC分类号： A61M500

    CPC分类号： A61B17/3421 ,  A61B2017/00243 ,  A61B2017/0243 ,  A61B2017/3445 ,  A61B2017/3449 ,  A61B2017/3488 ,  A61F2/2427

    摘要： The invention is a method to perform a surgical procedure within the beating heart. The instrument provides a seal to surround cardiac tissue, thereby defining a segregated surgical field within the body of the instrument. A suction device is preferred to remove blood and fluids from the surgical field so that a surgical procedure can be performed while the heart continues to beat. The instrument is particularly suitable for a procedure to repair defective or diseased cardiac valves, such as the mitral valve; a procedure which previously required that the heart be stopped so that the corrective surgical procedure could be performed.

    摘要翻译： 本发明是一种在搏动心脏内执行外科手术的方法。 仪器提供围绕心脏组织的密封，从而在仪器体内限定分离的外科视野。 抽吸装置优选从外科手术区域移除血液和流体，使得可以在心脏继续击打时进行外科手术。 该仪器特别适用于修复有缺陷或患病的心脏瓣膜如二尖瓣的手术; 以前需要停止心脏以便可以执行矫正外科手术的程序。

    Perfusion device for maintaining blood flow in a vessel while isolating an anastomosis
    68.
    发明授权
    Perfusion device for maintaining blood flow in a vessel while isolating an anastomosis 失效
    用于在分离吻合期间维持血管中的血液流动的灌注装置

    公开(公告)号：US06214022B1

    公开(公告)日：2001-04-10

    申请号：US09301019

    申请日：1999-04-28

    申请人： Charles S. Taylor ,  Alfredo R. Cantu ,  Son M. Gia ,  Jeff A. Krolic ,  Robert G. Matheny ,  Amr Salahieh ,  Ivan Sepetka

    发明人： Charles S. Taylor ,  Alfredo R. Cantu ,  Son M. Gia ,  Jeff A. Krolic ,  Robert G. Matheny ,  Amr Salahieh ,  Ivan Sepetka

    IPC分类号： A61B1708

    CPC分类号： A61B17/11 ,  A61B17/0469 ,  A61B17/12045 ,  A61B17/12109 ,  A61B17/12131 ,  A61B17/12136 ,  A61B17/1219 ,  A61B2017/1135 ,  A61B2017/12127

    摘要： A plurality of embodiments of a distal perfusion device are disclosed, which device facilitates anastomosis constructions by maintaining a dry anastomosis site while simultaneously maintaining blood flow distally in the blood vessel to prevent ischemia and reduce overall patient trauma. The perfusion device is configured for installation into a blood vessel such as a left anterior descending coronary artery through an incision therein, to which is to be grafted a distal end of a blood vessel such as an internal mammary artery. The device includes a central member of selected configuration and material, terminating at either end thereof in respective selectively tapered end members. A lumen extending through the central member and end members, and selected perforations in the end members, maintain blood flow through the perfusion device. A selected portion or portions of the device's outer circumference fit snugly within the artery in the regions beyond and/or at the anastomosis site, to maintain the latter free of blood. Several methods for deploying and removing respective embodiments of the device also are illustrated.

    摘要翻译： 公开了一种远端灌注装置的多个实施例，该装置通过维持干吻合部位来促进吻合结构，同时在血管中保持血液向远端流动以防止局部缺血并减少总的患者创伤。 灌注装置被构造成通过其中的切口安装到诸如左前降支冠状动脉的血管中，其将被移植到诸如内部乳腺动脉的血管的远端。 该装置包括选定构型和材料的中心构件，其终端位于相应的选择性锥形端构件的任一端。 延伸穿过中心构件和端构件的内腔以及端构件中选择的穿孔保持血流通过灌注装置。 装置的外周的选定部分或部分适合紧贴在吻合部位之外和/或处于吻合部位的区域内的动脉内，以保持后者无血液。 还示出了用于部署和移除设备的各个实施例的几种方法。

    Surgical instruments for making precise incisions in a cardiac vessel
    69.
    发明授权
    Surgical instruments for making precise incisions in a cardiac vessel 失效
    用于在心脏血管中进行精确切口的手术器械

    公开(公告)号：US6113616A

    公开(公告)日：2000-09-05

    申请号：US27611

    申请日：1998-02-23

    申请人： Charles S. Taylor ,  John J. Frantzen ,  Ivan Sepetka

    发明人： Charles S. Taylor ,  John J. Frantzen ,  Ivan Sepetka

    IPC分类号： A61B17/00 ,  A61B17/28 ,  A61B17/32

    CPC分类号： A61B17/32 ,  A61B17/320016 ,  A61B2017/00243 ,  A61B2017/00703 ,  A61B2017/00778 ,  A61B2017/2925 ,  A61B2017/320052

    摘要： Surgical instruments and methods for making substantially linear incisions, especially through walls of vessels, such arteries, specifically designed for coronary artery bypass graft procedures (CABG) on the beating heart. The invention is particularly useful to create the incision in the artery to which a bypass graft is sewn, typically the left anterior descending artery (LAD). The instruments allow incisions to be rapidly made, precisely measured and cleanly formed so that a bypass graft can be rapidly sewn in place, without undue trauma to surrounding tissue and excessive loss of blood. In one embodiment, a hand-held instrument has a cutting edge formed on the interior edge of a curved blade fixed near the end of the instrument. The tip of the blade has a point for penetrating the vessel wall which may have several alternate shapes to facilitate penetration of the vessel wall while minimizing to the surrounding tissue. In another embodiment the hand-held instrument includes a moveable member which creates an incision by engaging a cutting blade against a stop, cutting tissue therebetween, the stop including a pointed including a pointed tip similar to the previous embodiment. In another embodiment, the instrument features a motion-canceling member which compensates for the movement of the target surface to be incised. This embodiment has a cutting blade which is manipulated from a handle which is isolated from the movement of the tissue containing or proximate to the target of the incision.

    摘要翻译： 手术器械和方法，用于进行基本上线性的切口，特别是通过血管壁，这种动脉，专门设计用于搏动心脏上的冠状动脉旁路移植手术（CABG）。 本发明特别有用于在缝合旁路移植物的动脉中产生切口，通常为左前降支动脉（LAD）。 这些仪器允许快速地进行切割，精确测量和清洁地形成，使得旁路移植物可以快速缝合就位，而不会对周围组织造成过度的创伤和过度的血液损失。 在一个实施例中，手持式仪器具有形成在靠近仪器端部的弯曲刀片的内边缘上的切割刃。 叶片的尖端具有用于穿透血管壁的点，该点可以具有若干替代形状，以促进血管壁的穿透，同时使周围组织最小化。 在另一个实施例中，手持式器械包括可移动构件，其通过将切割刀片接合止挡件而形成切口，在其间切割组织，止动件包括类似于前述实施例的尖端，包括尖端。 在另一个实施例中，仪器具有补偿待切割的目标表面的移动的运动消除构件。 该实施例具有从手柄操纵的切割刀片，该手柄与包含或接近切口目标的组织的运动隔离。

    Surgical devices for imposing a negative pressure to stabilize cardiac tissue during surgery
    70.
    发明授权
    Surgical devices for imposing a negative pressure to stabilize cardiac tissue during surgery 失效

    公开(公告)号：US6032672A

    公开(公告)日：2000-03-07

    申请号：US870687

    申请日：1997-06-06

    申请人： Charles S. Taylor

    发明人： Charles S. Taylor

    IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/30 ,  A61B17/34 ,  A61B19/00

    CPC分类号： A61B17/00 ,  A61B2017/00243 ,  A61B2017/00703 ,  A61B2017/0243 ,  A61B2017/306 ,  A61B2017/3488 ,  A61B90/40

    摘要： The invention is devices and techniques which use a negative (suction) pressure or vacuum, applied through a surgical instrument, to fix the position of a portion of the surface of a beating heart so that a surgical procedure can be more easily performed. The devices apply a negative pressure at several points on the outer surface of the heart such that a portion of the heart is fixed in place by the suction imposed through the surgical instrument. Because the instrument fixes the position of the tissue, and because the instruments remain at a constant distance from the particular portion of the heart where the surgery is being performed, the device may also serve as a support or platform so that other surgical instruments or devices can be advantageously used at the site. In certain preferred embodiments, the devices described herein have structures to facilitate the use of additional surgical instruments such that the placement of negative pressure device permit the surgeon to advantageously manipulate the other instruments during surgery. The negative pressure is preferably imposed through a plurality of ports which may be disposed in a substantially planar surface of the instrument which contacts the cardiac tissue.